Pet Allergy - The Asthma Center

Education and Research Fund
y
g
r
e
l
Al
theasthmacenter.org
.
t
e
P
an
em
r
o
m
It’s
an
th
e
l
b
a
age
The basics
We love our pets, and they love us. Over half of
all homes in the US have a cat or dog, accounting
for 100 million pets. A dog or cat quickly becomes
a member of the family, and unfortunately, many allergic animal lovers find themselves facing the daily
discomfort of persistent allergy symptoms.
About 5-10% of Americans are allergic to pet
allergens. The most sensitive individuals may suffer
greatly from the slightest exposure to animal dander,
and reactions to cat dander can be particularly explosive. But homes aren’t the only high-dander environments. Sensitive individuals may display reactions at
work and other public places due to the presence of
pet dander. Reactions may occur at home, in hotel
ink
h
t
u
o
y
.
rooms and friends’ homes, even if a pet is not present at the time. Where pets are in residence, dander
will concentrate in local reservoirs such as curtains,
upholstery, rugs, clothing, bedding and air ducts,
which are constant sources of allergen, even when
the pets and their families have moved on to a new
home.
Interestingly, dander may be inadvertently transported by pet owners to animal-free locations. In
these instances, exposure is often indirect (allergen in
ventilation systems, or dander attached to people).
Continuous exposure may lead to the mysterious
onset of allergy symptoms without an obvious cause.
And worse, untreated animal dander allergy may silently trigger difficult-to-manage asthma, allergic sinusitis or allergic rhinitis.
Who’s at risk?
Heredity plays a key role, as pet allergy often runs
in families. If either parent suffers from pet allergies,
the chance of a child developing the condition significantly increases. If both parents are allergic, the
risk of a child developing allergy can occur in up
to 80% of their offspring.
What does “dander” mean?
Most people believe airborne pet fur/hair causes allergy symptoms, which is not actually the case. Airborne saliva and urine-derived proteins are a major
source of pet allergen.
Sebaceous glands in the skin also produce these
protein allergens. Male cats and dogs have greater
amounts of secretion and are often more allergenic
than females or neutered males.
Desquamated (epithelium (shed upper layer of
skin) and saliva are rich in water-soluble protein,
which causes allergic reactions. Pet hair alone has
little water-soluble protein, with the exception of deposited saliva, which occurs when a pet licks its fur.
While the fur/hair may be coated with allergen
proteins deposited from dried saliva, the airborne
microscopic flakes of animal dander from the
skin remain the major source of pet allergen.
indirect contact (airborne allergen inhaled into the
nose and lungs) or by transfer of the dander directly
to nasal and/or ocular mucosa by direct contact with
pet allergen from contaminated hands or clothing.
Pet allergens can remain in a home for up to
six months or more after a pet has been removed.
Lower levels of animal dander allergen can even persist for years because of urine contamination (soaked
into carpets, furniture, and floors), or dander in hidden areas (air ducts, basements, attics, and in and
around furniture, closets and appliances).
Low levels of allergen may even be present as a
result of a pet owned by a previous occupant of a
dwelling, or furniture. Further, pet allergen may travel into your home or office on pet owners’ clothes or
hair.
Common heating or air conditioning systems in
apartment buildings may allow pet allergens present
in one apartment to contaminate a nearby pet-free
apartment via air ducts. Pet-dander-contaminated
classrooms, offices, and mass transit are common
sources of indirect exposure.
What about hypoallergenic pets?
There isn’t much scientific evidence in medical literature to suggest that any dog or cat currently available
is non-allergenic. As long as cat and dogs have allergen proteins in their skin, saliva, blood and urine, exposure can aggravate allergies. Nevertheless, small
How dander gets to you
dogs that lack a winter or second coat (terriers and
Pet dander can cause allergy symptoms through poodles) that shed less dander (along with some hybrid breeds) may offer reduced allergen exposure.
Also, a recently developed
hypoallergenic cat (for
about $5000) may offer a
better-tolerated hypoallergenic alternative.
“Hypoallergenic”
inBEDDING
UPHOLSTERY
87
dicates less or lowered
capacity to cause allergy.
CLOTHING
HAIR
However, until scientific
evidence confirms the
CITY LINE BUS
presence of low specificPUBLIC TRANSIT
CARS
pet allergen production,
OFFICE
labeling an animal as “hypoallergenic” is not necessarily helpful or accurate.
Common dander reservoirs
RUGS
SCHOOL
While certain cat breeds may produce fewer potent
allergens—such as the Siberian and Russian Blue—a
cat or dog with low allergenicity can still provoke serious allergy symptoms in a highly-sensitive individual.
Does pet allergy fade?
Allergy to household pets can either diminish or increase over time. For example, when college students
return home after a long absence, they may experience
a flare of allergy symptoms following re-exposure to
their pets. Living with a cat or dog can, over time, lead
to some desensitization or just the opposite effect—
increased sensitivity to shed allergens. Unfortunately,
this process is entirely unpredictable.
Cat allergy explained
The major cat allergen is Fel d 1, found in saliva, blood
albumen, urine, dander, and sebaceous gland excretions. Cat allergy is more common than dog allergy
and generally more severe. In fact, cat hypersensitivity
can effect up to 25% of all allergy sufferers.
Feline allergens are produced in large amounts,
particularly from male non-neutered cats. The dander
is extremely light in weight, small in size, constantly
mobile, very sticky, and carried far and wide by pet
owners.
Dog allergy explained
Dog dander is rich in Can f 1 or Can f 2 allergens (the
Can f 1 allergen is higher in non-neutered males).
Dogs with a second winter coat (for example, large
working dogs) may cause more indoor hair pollution
than short-haired, single-coat dogs such as terriers or
poodles. Mixed-breed or hybrid small dogs may have
even less hair, producing less indoor contamination.
However, there is no such thing as a non-allergenic dog, and even a “hypoallergenic” breed is a serious
health risk to highly sensitivie patients. Washing your
dog once or twice a week, cleaning your dog with
Allerpet, or wiping down the coat with a damp microfiber may diminish dander concentration.
Symptoms of pet allergy
Some pet owners will have sudden and dramatic
symptoms when exposed to cats or dogs, while others
suffer from persistent low-grade symptoms that only
clear up after days or weeks away from their homes.
Highly sensitive individuals may have trouble
controlling symptoms, even with comprehensive
medical treatment. Chronic exposure to pet dander
among allergy sufferers can lead to worsening of sinusitis, asthma, nasal allergy, eye allergy, sleep apnea
and snoring, eczema and contact hives.
Exposure to cat or dog dander may worsen
other allergic reactions, even seasonal allergy. For
example, exposure to a cat or dog during the winter may worsen spring and fall seasonal allergy
symptoms, as the immune system may be “primed”
or activated due to year-round allergen exposure.
Some individuals originally allergic to pets, may,
over time, become “immune” or desensitized to
dander from their own pets. However, in others, allergic reactions to one’s pet can worsen over time.
How to reduce dander
n E liminate or minimize animal allergen exposure
n Neuter male cats and dogs to lower their allergen production.
n Vaccum with a good HEPA filter vacuum cleaner
twice a week.
n Wash hands immediately after contact with
pets.
n Avoid rubbing eyes and nose when around
pets
n Use a steam vapor cleaner to clean your home,
rugs and upholstery.
n Put filters on bedroom ventilation grids.
n Washing pets twice a week can reduce allergens
by 85%. Also, use a damp micro fiber cloth to
rub down pets regularly.
n Confine pets to one room of the house.
n Remove allergens from your home or work environment when possible.
n Keep pets out of sleeping areas. Close bedroom
doors and run HEPA filter air cleaners.
n Wash bedding in hot water once per week.
n Clean floors and walls with electrostatic cloths
like the Swiffer, or Grab-It products which attract
and hold pet hair and dander.
n Immunotherapy. Allergy injection therapy is
unique in that it can specifically lower one’s sensitivity to a pet.
n See additional medical treatment at right.
Treatment
Although pet allergy symptoms may diminish through
avoidance and cleaning, it may not be possible to adequately limit pet allergen exposure for all patients. Further, exposure to pet allergen from unknown sources,
or sources outside of one’s control may lead to persistence of symptoms. Under these circumstances, medical treatment and allergy shots may effectively control
pet allergy symptoms when other measures fail.
Treament options include medications and immunotherapy (allergy shots.)
Medications
n O
ral antihistamines: (e.g. Clarinex, Claritin, loratadine, Zyrtec, Xyzal, Allergra, fexofenadine, etc.)
n Nasal sprays: Antihistamines, mast-cell stabilizers,
corticosteroids (e.g. Nasalcrom, Astepro, Patanase,
Nasonex, Veramyst, Nasacort, Omnaris)
n Eye drops: Antihistamines, mast cell inhibitor,
corticosteroids, (e.g. cromolyn sodium, Pataday,
Optivar, Alrex)
n Leukotriene modifiers (e.g. Singulair, Accolate,
Zyflo)
n Nasal sinus rinse with saline
n Asthma medications: Advair, Symbicort, Asmanex,
Proventil, Proair
n Xolair (omalizumab) for severe allergic asthma
(anti-IgE injection specifically)
unique benefit of immunotherapy is that decreased allergy symptoms may persist long after immunotherapy
is discontinued, indicating the long-term benefit of this
treatment.
When a pet cannot be removed from the home and
continues to cause significant allergy symptoms despite
good environmental controls and use of medication, immunotherapy becomes the treatment of choice.
About SLIT
Injection or subcuteanous immunotherapy is the recommended treatment at this time for the induction of
tolerance. SLIT or (sublingual immunotherapy) is not
FDA-approved for therapy and therefore at this time,
cannot be recommended as a legitimate treatment for
pet allergy.
Animal allergens don’t originate
from their fur, but from their saliva
and skin. Because cats clean themselves frequently, their saliva dries
on their fur, flaking off to become
an airborne allergen that finds its
way into every aspect of your life.
Immunotherapy
Allergy shots (or immunotherapy) are a unique form of
treatment which specifically lowers the patient’s sensitivity to his or her pet and can work well where other
forms of therapy prove inadequate.
This treatment consists of a series of injections
containing specific allergens to cat or dog. Injections
are administered over a long period of time, beginning with tiny doses which are gradually increased to
induce immunologic tolerance to the pet. Initially, the
dose is diluted enough so as not provoke an allergic
reaction. Over time, an increased dose results in growing tolerance to the pet allergen exposure.
Immunotherapy is highly recommended if a pet
in the home causes frequent symptoms that avoidance and medications canot properly manage. A
For more information, visit us online | theasthmacenter.org